The number of Americans over age 65 is expected to reach 72 million in the next 25 years, but this population is historically difficult to reach for participation in exercise programs. In a recent Health Education Research paper, Harden, Estabrooks and co-authors at the University of Illinois described an evaluation tool to determine whether contact has been made with the intended population.

They evaluated a study conducted by collaborators across 5,000 square miles of central Illinois, where approximately 300,000 residents fall into the older adult category. Since 36 percent of older adults do not meet physical activity recommendations, researchers aimed to recruit about 105,515 people to participate in the DVD-based fitness program.

Researchers found that, despite the digital era, newspaper advertisements were still the most successful means for recruiting at-risk older adults.

They also found that each monthly DVD was viewed by more than 80 percent of the participants, indicating that the program was actually used once the audience was reached.

The researchers used six different recruitment strategies to reach older adults, of which 563 expressed interest in the program, with 307 ultimately joining.

“We found a seemingly dismal reach of just .3 percent of eligible participants,” Harden said. “From a public health perspective, that may seem drastically low. However, one of the main arguments in our study is that the use of multiple indicators— and an appropriate denominator— is important to more accurately assess the degree to which the intervention reached at-risk older adults."

The team looked at the communication method used for recruitment, the demographics of the population, the level of participation once recruitment was achieved, and the success of each intervention in participant homes.

All four of these indicators align with a public health framework called RE-AIM, short for Reach, Effectiveness Adoption, Implementation and Maintenance.

“Each one of these indicators gives us an opportunity to intervene so we can make sure we’re getting the participants who would most benefit from physical activity,” Estabrooks said.

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